Due to limited retrospective data, the use of enoxaparin in specialty populations—including those with renal dysfunction, extremes of body weight, pregnant patients and pediatric patients–has not been studied in clinical trials. The authors discuss the challenges in predicting the pharmacokinetics of enoxaparin dosing in these patients and the difficulty in obtaining antiXa levels in hospitalized patients.

The landscape of migraine therapy is set to change with the introduction of new classes of medications aimed at providing options for patients who have not responded to previous therapies. However, the pricing of the new agents will likely be a key determinant in the extent of their use in clinical practice.